New York HIV case prompts discussion on prevention for gay men

Reports of an HIV-positive New York City man infected with a rare strain of HIV resistant to 19 of the 20 available antiretroviral drugs has prompted a heated discussion about unsafe sex among gay men, including why many HIV-prevention plans stressing condom use have failed, The New York Times reports. Many AIDS experts and activists say that although virtually all gay men know that sex without a condom can expose them to HIV, they choose to have unprotected sex anyway, many times while under the influence of crystal methamphetamine. Some activists are considering radical measures to try to prevent HIV-positive men from exposing others to the virus and to stop HIV-negative men from placing themselves at risk, the Times reports. Such measures could include showing up at places where meth-fueled sex parties routinely happen and then confronting the participants, or attempting to prevent some sexual hookups arranged online. For some AIDS activists, such drastic steps are seen as a last-ditch effort to get gay men to act more responsibly before the government steps in with even more restrictive programs that target those who engage in unprotected sex. "Gay men do not have the right to spread a debilitating and often fatal disease," Charles Kaiser, author of The Gay Metropolis, told the Times. "A person who is HIV-positive has no more right to unprotected intercourse than he has the right to put a bullet through another person's head." Even some AIDS organizations, like Gay Men's Health Crisis, while not endorsing a particular prevention approach, are considering trying new ways to prevent the spread of the virus through unprotected sex. Ana Oliveira, executive director of GMHC, told the Times, "It makes a community stronger when we take care of ourselves, and if that means that we have to be much more present and intervene with people who are doing this to themselves and others, then so be it." But more aggressive HIV prevention tactics worry some AIDS activists, who say the privacy rights of gay men and confidentiality rights of HIV-positive people could be violated by those who try to regulate their sexual behavior. Others say even attempting to identify the sexual partners of crystal meth users to warn them of HIV infection risks could be too intrusive. Walt Odets, author of In the Shadow of the Epidemic: Being HIV-Negative in the Age of AIDS, told the Times such tactics remind him of a witch hunt. He instead advocates determining and addressing the root causes of risky behavior, including drug abuse and unprotected sex, as the best way to prevent HIV infections among gay men.